DESCRIPTION: (Applicant's Abstract) This is a competing continuation application building on a 2-year NIDA treatment development project to refine a community reinforcement and family training (CRAFT) approach for counseling concerned significant others (CSOs) to enhance behavior change and treatment initiation for loved ones with drug abuse and dependence. It will also represent the first controlled trial of Twelve-Step treatment approaches for drug abusers and their CSOs. A randomized clinical trial (n=30 per group) will formally compare the efficacy of manual-guided CRAFT and Twelve-Step Facilitation (TSF) counseling interventions. To balance the potential impact of 1 2-step group attendance in TSF, we will also assess the benefit of adding an aftercare support group to CRAFT. Therapeutic impact will be evaluated on three domains: (1) the identified patient's drug use and treatment utilization; (2) the CSO's functioning, and (3) the quality of their relationship and family environment. To standardize the quality and availability of treatment for IPs, a second phase study is embedded in which IPs will be given complementary CRA or TSF therapy. Multidimentional follow-up assessment will extend to 18 months for CSOs and to 12 months for IPs. Two small substudies are further proposed to: (1) extend follow-up of pilot treatment development project clients through 24 months, and (2) establish the test-retest reliability of the Form 90-D structured interview for drug use and problems. As a whole, the project will ascertain the effectiveness of these approaches for initiating and offering early treatment for unmotivated drug abusers. Principal analyses will focus on the relative efficacy of compared treatments, processes underlying behavior change, and client characteristics associated with differential therapeutic response.